Access to health care for people who live in rural areas is problematic, both nationwide and in Alabama. Rural areas typically have fewer physicians per capita than urban areas, and transportation systems typically are poorly developed. The number of hospitals in rural areas is decreasing, and hospitals that do exist often are losing resources such as medical specialists and technical equipment. In combination, these characteristics form a major barrier to the delivery of optimal health care in general, and of state-of-the-art cancer care in particular. At the same time, a substantial network of medical and nursing cancer care specialists has been established, both in specialized cancer centers and in community centers. It follows that delivery of state-of-the-art cancer management could be improved by enhancing the linkages between primary care providers and such cancer specialists. Accordingly, the broad purpose of the proposed project is to build stronger relationships between primary care providers in. a rural seven county area of Alabama and cancer specialists in four medical centers. Within this broad purpose, this rural cancer initiative will strive to promote the following specific types of linkages: (a) Patient Care Linkages, (b) Treatment Center Linkages, (c) Nursing Linkages, (d) Linkages to Clinical Trials, (3) Linkages to Community Resources, and (f) Linkages to Sources of Cancer Information. A final goal of the project will be to promote strategies for earlier detection of cancer.